Osimertinib (Tagrisso) has demonstrated significant benefit in the frontline metastatic and adjuvant settings in patients with stage IV and stage IB-IIIA EGFR-mutant non–small cell lung cancer (NSCLC), respectively, explained Lara A. Kujtan, MD, but added that the ongoing phase 3 FLAURA2 (NCT04035486), LAURA (NCT03521154), and NeoADAURA (NCT04351555) trials could also position the third-generation inhibitor for use in the locally advanced and neoadjuvant settings.
In patients with newly diagnosed EGFR–mutant advanced NSCLC, osimertinib displayed an overall survival (OS) and progression-free survival advantage vs erlotinib (Tarceva) and gefitinib (Iressa), regardless of the presence of brain metastases, in the phase 3 FLAURA trial. Data from the study served as the basis for the agent’s approval in this setting in 2018.
In patients with stage IB to IIIA EGFR-mutant NSCLC, adjuvant osimertinib demonstrated a significant improvement in disease-free survival (DFS) vs placebo in the phase 3 ADAURA study; OS data are not yet mature. In 2020, the FDA approved the agent for use in this setting.
“Future research will be looking at osimertinib in other stages of disease, mainly stage IIIB and IIIC,” said Kujtan. “How does osimertinib fit in there, especially for patients who are [currently] getting immunotherapy after they’ve completed concurrent chemotherapy and radiation? We’re also looking at [osimertinib in] the neoadjuvant setting as well, and how osimertinib can benefit those patients.” Read more.